pfl-renew-app

Document Sample
pfl-renew-app Powered By Docstoc
					Renewal
                                                                                        845 Cambie Street


PRACTITIONER OF
                                                                                        Vancouver, B.C. Canada V6B 4Z9
                                                                                        Telephone: (604) 669-2533
                                                                                        Toll-free within B.C. 1-800-903-5300
                                                                                        Facsimile: (604) 687-0135

FOREIGN LAW                                                                             TTY: (604) 443-5700
                                                                                        E-mail: memberinfo@lsbc.org
                                                                                        www.lawsociety.bc.ca



                                      PLEASE READ BEFORE COMPLETING APPLICATION
This application form must be completed fully and precisely, and the declaration must be declared before a notary public,
commissioner, or other person authorized by the Evidence Act, RSBC 1996, c. 124, s. 69 to take declarations. Omissions or
inaccuracies in your answers may delay your application. If the space provided for any answer is insufficient, complete
your answer on a separate sheet, sign the sheet and staple it to this application form. The Credentials Committee may
investigate or verify any information supplied on this application form, and may require further explanation from you.



PART A — NAME AND IDENTIFICATION

1.       Name:
                            Surname                          Given names in full

2.       Addresses:
         Office:


                                                     Postal Code                   Telephone

         Home:


                                                     Postal Code                   Telephone

PART B — PROFESSIONAL STANDING

3.       Have you ever been refused admission to, been disciplined by or been disbarred or struck from membership in a law
         society or other professional organization?  Yes          No 

         If “yes,” give full particulars:




4.       Have you ever resigned from a Law Society or other governing body in exchange for disciplinary proceedings not
         being taken against you?            Yes       No 

         If “yes,” give full particulars:




5.       Are you aware of any complaint or charge pending against you in your professional capacity, which has not yet come
         to the attention of your law society or governing body, which might result in disciplinary action being taken against
         you?         Yes            No 

         If “yes,” give full particulars:




[2007-April]
PART C — PROFESSIONAL LIABILITY INSURANCE

6.       Name of insurer:

7.       Address of insurer:



8.       Policy no:

9.       Policy period: From                                       , 20              to                               , 20

         [Under Law Society Rule 2-18(6)(b), a practitioner of foreign law permit ceases to be valid if his or her liability
         insurance coverage is discontinued or reduced. A practitioner who has been issued a permit has a continuing
         obligation to inform the Law Society of the cancellation of, or any significant change to, his or her liability insurance
         coverage.]

10.      Limits of liability:

         (a)       for all claims arising out of a single act, error or omission or a series
                   of related acts, errors or omissions (Cdn. dollars or equivalent):                 $

         (b)       annual aggregate per insured:                                                      $

11.      Member deductible per claim:                                                                 $

12.      Are the limits of liability inclusive of claims expenses and deductible?          Yes       No 

         Please enclose with your application documentary evidence that you are insured as set out above and that it
         extends to services rendered by you while acting as a practitioner of foreign law in British Columbia.


PART D — GOOD CHARACTER

If you answer “yes” to any of the questions in this Part, give full particulars on a separate sheet, including the applicable
dates, places, nature of acts or offences, and penalties.
                                                                                                          Yes      No
18.      Have you ever been charged, in Canada or elsewhere, with any crime, offence or
         delinquency under a statute or ordinance?                                                                

19.      Have you ever, or has any company or partnership of which you are or were a
         director, officer or employee, ever been the subject of bankruptcy proceedings?                              

20.      Have you ever been a defendant in any civil action in which allegations of fraud, theft
         or misrepresentation were made against you?                                                                  

21.      Is there, at the present time, a civil action or a civil judgment outstanding against you?                   

22.      Have you ever failed to obey a court order?                                                                  

23.      Have you ever been imprisoned for failing to obey a court order?                                             

24.      Have you ever been denied, or had revoked, a licence or permit the procurement of
         which required proof of good character?                                                                      




[2007-April]                                                      2
PART E — MEDICAL FITNESS

The practice of law is often rigorous, demanding a high level of physical, mental and emotional health. Any disability, which
would render you incapable of practising law competently puts clients’ interests at risk, and harms the profession’s reputation.
Having said that, the Benchers recognize that everyone experiences pressures in life, and we all respond to those pressures
differently. You may be quite capable of acting as a consultant competently, in spite of past physical, mental or emotional
problems.

In asking the questions in this Part, the Benchers are seeking information that will assist them in determining whether you will,
in the future, be capable of acting as a practitioner of foreign law competently, and the information provided will be held in
strict confidence.

The fact that you may have sought professional assistance for an alcohol or drug dependency, or for a mental illness or
emotional problem, is not a bar to act as a practitioner of foreign law. It may call for further enquiry, but it would only p revent
issuance of a permit if the Benchers concluded that the dependency, illness or problem would render you incapable of acting
competently as a practitioner of foreign law.

In most cases, evidence of having sought professional assistance is positive evidence, as it suggests that you are actively
seeking to deal with the condition and take control of your life. If you would like to discuss a personal concern confidentia lly,
please contact a Bencher or the Executive Director.

If you answer “yes” to any of the questions in this Part, please give full particulars on a separate sheet.

Since you last completed an application for a permit or renewal of a permit to act as a practitioner of foreign law:

1.       Do you now have or have you ever had a dependency on alcohol or a drug?                              YES           NO
2.       If "yes," are you now under treatment or counselling, or have you ever received                      YES           NO
         treatment or counselling for that dependency?
3.       Have you ever been treated for schizophrenia, paranoia, or a mood disorder described                 YES           NO
         as a major affective illness, bipolar mood disorder or manic depressive illness?


PART F — RESIDENCE

29.      Do you reside full-time in British Columbia?                    Yes            No 


         If “no,” describe your circumstances in detail, including the frequency with which you act as a practitioner of foreign

         law in British Columbia:




30.      Address in British Columbia:

         Name of firm:

         Street address:

         Postal code:                                             Telephone: (            )




[2007-April]                                                     3
                                                 DECLARATION OF APPLICANT

I, ________________________________________________________________________________,                                         DO     SOLEMNLY
DECLARE THAT:

1.        I am the applicant described in this application.

2.        I have personal knowledge of the information I have added in completing this application, and that the information is
          true, accurate and complete;

and I make this solemn declaration conscientiously believing it to be true and knowing that it has the same legal force and
effect as if made under oath.

Declared before me at _____________________________
                                 city
______________________________, this _______ day of
       country
___________________________ , 20 _______.



____________________________________________________                                      ______________________________________
A notary public, commissioner, or other person authorized by the                                    Signature of applicant
Evidence Act, RSBC 1996, c. 24, s. 69 to take declarations.



                                 APPLICANT’S AUTHORIZATION AND UNDERTAKING

I, _________________________________________________________________, the applicant in this application for
permission to act as a practitioner of foreign law in British Columbia:

1.        grant to the Law Society of British Columbia permission to ask any person, government, educational institution,
          police force, military authority, governing body or other organization about anything relevant to my application,

2.        authorize any person, government, educational institution, police force, military authority, governing body or
          otherorganization enquired of under this authorization, to provide to the Law Society of British Columbia all
          informationor documents requested by that Society;

3.        undertake that, if permitted to act as a practitioner of foreign law in British Columbia, I will submit to the jurisdiction of
          the Law Society of British Columbia, and will comply with the Legal Profession Act, the Law Society Rules and the
          Professional Conduct Handbook.




                            Date                                                                 Signature of applicant



                                                                IMPORTANT
Please ensure that you enclose with this application:
    any separate sheets used in the completion of any of the questions on this form; the separate sheets must be signed by
     you and stapled to this form;
    a certificate of good standing from each Law Society or other governing body of which you are a member;
    documentary evidence that you carry professional liability insurance as described in Part C, and that it extends to
     services rendered by you while acting as a practitioner of foreign law in British Columbia;
    the permit application fee fixed by Rule 2-22(c) of the Law Society Rules;
    any other documents relevant to this application.
The information contained on this form is collected under authority of Rule 2-18(1)(a) of the Law Society Rules. The information provided will
be used to process applications for a permit by practitioners of foreign law to carry on the business of providing legal services to the public. If
you have any questions about the collection and use of this information, contact the Freedom of Information Analyst, Law Society of British
Columbia, 845 Cambie Street, Vancouver, B.C. V6B 4Z9, Tel. (604) 669-2533
[2007-April]                                                            4

				
DOCUMENT INFO